How Therapy Works

San Diego Therapist, Counselor Jan Rakoff, LCSW

Psychotherapy works differently for different people. While some may require many counseling sessions in order to feel better, others may feel self-assured after just a few short weeks. Regardless of the length of time you spend in therapy, the underlying purpose of our practice is to have you understand that your thoughts, feelings, and behaviors are all interconnected. Therapy is not a “quick fix” or “Band-Aid” approach that attempts to mask the problems at hand; rather, therapy is a process and therefore takes time and dedication from both the client and the counselor. Therapists strive to create a warm and safe environment that is compassionate and sensitive in nature.

The initial session will include formal intake procedures and a full exploration of your past, and your present problematic symptoms or behaviors that have caused you to seek therapy. Sometimes the initial session will need to be divided into two parts, perhaps due to the length, complexities, and multi-faceted issues you may be dealing with. Also, for others it can be overwhelming to re-tell their entire life story in just one visit. In circumstances like these, a divided initial session would be recommended. Once we have a comprehensive understanding of you and your story, and have had the opportunity to become acquainted to make you feel that you are in a safe environment, we can begin our formal therapy sessions together.

Over the many weeks of counseling sessions, we will become better acquainted with one another, and begin to form a strong therapeutic alliance. We will then attempt to identify patterns, antecedents, and consequences of your behavior. While this is a process, and therefore takes some time, it is important to understand the connection between the way we think, feel, and behave. Once we are able to pinpoint where the difficulty lies, which is usually in our thought process, we can then work towards helping you cognitively re-frame your ways of thinking.

This skill will subsequently lead to changes in the way you feel and also alter the way you behave. For many of us, our thoughts are so automatic that we don’t always realize that what we are thinking about is contributing to the end result of problematic emotions and/or behaviors. This type of therapy breaks the components down into manageable pieces and analyzes them with you to identify where you are (upon entering therapy) and where you would like to be (the goal of the therapy). Through analyzing your thoughts together, we are usually able to find patterns and general ways of thinking that you embody. Once we identify the problematic thoughts, we are able to help you challenge these often irrational thoughts, by proving them (finding evidence that supports them) and also disproving them (finding evidence that does not support them).

This will help you get to know yourself better, gain self-confidence, and feel more in control of the therapeutic process. We will work together to assist you in re-framing these negative cognitions, by attempting to look at things from another perspective that perhaps you didn’t realize existed. Since many of us are self-critical and constantly second-guessing ourselves, the underlying theme of our therapy is to help you work on these negative thoughts that are causing you emotional pain and suffering. Without being self-aware and mindful of our thinking patterns and how they influence our feelings and behaviors, we find that the suffering does not occur solely on an individual basis, but also extends to those who are closest to you. This can affect relationships between spouses, friendships, and the way you parent your children or treat your colleagues at work. As you can see, these once thought to be “private” matters become problematic when they begin to affect your personal feeling of well-being, but also your daily functioning with those around you.

Overall, this type of therapy will teach you coping skills, so that when the inevitable, yet problematic, activities of daily life begin to take a toll on you, you are able to respond effectively and positively. Being a practical, interactive therapist, I always ensure that the client is involved as much as possible in our treatment goals and planning. Rather than telling you what to do, I can educate and teach you some of the problem-solving skills and evaluate how they have or have not worked for you.

I will be there to provide constructive and continuous feedback to help you achieve solutions that are manageable, realistic, and attainable. Upon completion of therapy, you will have the tools you need to become a powerful agent for self-change since you will now have a greater understanding of the way your thoughts, emotions, and behaviors all interplay with one another. As my previous clients have reported, you will enjoy lower levels of anxiety and stress, decreased conflicts, and an improved quality of life due to your new found understanding of yourself, including the relationship between your thoughts, feelings, and behaviors.

How do I know if therapy is right for me?

There is no clear cut answer to this question. However, if you are feeling overwhelmed by situations or experiences in your life, feel as if no one understands you, and are beginning to feel helpless, therapy may be right for you. Of course, the choice to seek help from a counselor is always yours. You may begin therapy sessions and find out that it is not for you. In general, therapy usually benefits most who seek it. Usually if you choose to find help from a therapist, it means you recognize that you have a problem and need some help and support to re-gain control of your life.

How can a person who doesn’t even know me help me with my problems?

Unlike a friend or a family member, a therapist acts as an objective, unbiased individual who is able to listen and give appropriate feedback, without the interference of an emotional attachment.
A therapist can be a listener, supporter, and sometimes even a teacher who helps you learn strategies and gain insight to your current problems that are causing these unbearable feelings.

If I seek therapy now, does that mean I’ll always need it?

Just because you choose therapy at this point in your life, it does not mean that you will always need therapy. Everyone goes through challenging situations in their lives where they could benefit from some outside assistance. Going to therapy does not mean you are “crazy” or “incapable” of handling your problems. In fact, it means you have the capacity to recognize that you need some help, which takes a strong-minded, self-aware individual.

How can therapy help me?

Therapy provides you not only with support and an opportunity to freely speak about your feelings and problems, but it also teaches you coping mechanisms and strategies that can be generalized and applied to other areas of your life. Many people who have attended therapy report improved interpersonal relationships as well as personal growth and self-awareness. However, the benefits you receive from attending therapy sessions depend on your willingness to fully participate in the therapeutic process and apply it to your daily living.

Is what I say during therapy confidential?

Yes, everything you say during a therapy session is kept confidential and private. The only exception to this is if you tell me that you are intending to harm yourself or others. Otherwise, everything we talk about is completely confidential.

How often do I have to attend therapy?

Everyone moves and heals at different paces, so the length of time you will need to attend therapy depends on how quickly you heal and how committed you are to the therapeutic process. I also recognize that people have busy lives and other commitments. However, we will typically meet once per week, depending on your availability.

How long are therapy sessions / appointments?

Appointments are usually one hour in length, but again, this depends on your schedule and availability.

How much will therapy cost and will my insurance cover it?

I have a sliding scale which we can discuss when you contact me. Most PPO Insurance will cover a portion of the cost.

How can I get started?

Please contact me at 1.858-481-0425 to set up an appointment for therapy in San Diego.

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